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  本文選題：電針　切入點：麥粒灸　出處：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的通過觀察肩周炎患者治療前后的疼痛指數(shù)、關(guān)節(jié)活動度和臨床癥狀的變化情況,客觀評價電針結(jié)合麥粒灸治療肩周炎的臨床療效,為選擇更具可行性且療效高的治療方案提供一定參考。方法選取在廣東省中醫(yī)院針灸科、傳統(tǒng)療法科門診就診的符合中西醫(yī)肩周炎診斷標(biāo)準(zhǔn)的患者為研究對象。選擇其中符合納入條件的60例患者,按照隨機對照原則,以1：1的比例分成觀察組與常規(guī)組,每個組分別有30例。觀察組采用電針結(jié)合麥粒灸療法,常規(guī)組單純采用電針療法,以肩毭穴、肩毼穴、肩貞穴、肩前穴、阿是穴為針刺處方的主穴,結(jié)合遠端配穴。兩組患者均每天治療一次,每周6次,治療兩周后評定療效。以疼痛指數(shù)(VAS)、關(guān)節(jié)活動度(ROM)和Constant-Murley (CMS)肩關(guān)節(jié)功能評分系統(tǒng)作為觀測指標(biāo),運用統(tǒng)計學(xué)方法,分析、比較兩組治療前后的評分結(jié)果。結(jié)果1.治療前相關(guān)資料的比較,兩組患者在性別、年齡、病程以及VAS、ROM及CMS肩關(guān)節(jié)功能評分方面,差別不存在統(tǒng)計學(xué)意義(P＞0.05),表明兩組具有可比性。2.兩組患者治療后的VAS評分,與治療前比較均有明顯下降,差異均有統(tǒng)計學(xué)意義(P＜0.05),說明兩組療法都能改善疼痛；與常規(guī)組比較,觀察組的VAS評分小于常規(guī)組,差異存在統(tǒng)計學(xué)意義(P＜0.05),說明觀察組改善疼痛的程度要高于常規(guī)組。3.兩組患者治療后的ROM評分,與治療前比較均有明顯提高,差異均有統(tǒng)計學(xué)意義(P＜0.05),說明兩組療法都能改善活動度；與常規(guī)組比較,觀察組的ROM評分高于常規(guī)組,差異有統(tǒng)計學(xué)意義(P＜0.05),表明觀察組比常規(guī)組更能改善關(guān)節(jié)活動度。4.兩組患者治療后的CMS評分,與治療前比較均有明顯上升,差異均有統(tǒng)計學(xué)意義(P＜0.05),說明兩組療法都能改善肩關(guān)節(jié)功能；與常規(guī)組比較,觀察組的CMS評分高于常規(guī)組,差異有統(tǒng)計學(xué)意義(P＜0.05),提示觀察組在改善肩關(guān)節(jié)功能方面優(yōu)于常規(guī)組。5.與治療前比較,兩組療法在改善肩周炎的臨床癥狀和功能方面均取得較好的療效,觀察組方面,治愈有7例,顯效達15例,有效為7例,無效則1例,總有效率為96.67%；而常規(guī)組方面,治愈有4例,顯效為9例,有效達13例,無效有4例,總有效率為86.67%。兩組整體療效的比較,差異存在統(tǒng)計學(xué)意義(P＜0.05),可見觀察組比常規(guī)組更優(yōu)。結(jié)論本課題觀察、探討了電針結(jié)合麥粒灸治療肩周炎的臨床療效,結(jié)果顯示,單純的電針療法能有效減輕患者的疼痛、改善關(guān)節(jié)活動度和提高肩關(guān)節(jié)功能,而電針結(jié)合麥粒灸療法在這些方面更優(yōu)于電針療法,療效更顯著,可操作性高,值得在臨床推廣應(yīng)用。
[Abstract]:Objective To observe the patients before and after treatment of periarthritis of shoulder pain index, joint activity and changes of clinical symptoms, objective evaluation of clinical efficacy of electric acupuncture combined with moxibustion treatment of periarthritis of shoulder, provide a reference for the selection of more treatment feasibility and high curative effect. Methods in the Guangdong Province Traditional Chinese Medical Hospital Department of acupuncture and moxibustion, traditional therapy clinic patients meet the standard the diagnosis of scapulohumeral periarthritis of traditional Chinese medicine and Western medicine as the research object. Select 60 cases which meet the inclusion criteria were randomly divided into observation group with the ratio of 1:1 and the conventional group, each group had 30 cases. The observation group used electro acupuncture combined with moxibustion therapy, conventional group treated with electro acupuncture therapy, acupoint Dou shoulder to shoulder. He point, energy-saving, shoulder point, Ashi acupuncture as main prescription, combined with distal acupoints. Two groups of patients were treated once a day, 6 times a week, two weeks after treatment To evaluate the curative effect. The pain index (VAS), joint activity (ROM) and Constant-Murley (CMS) of shoulder joint function scoring system as observation index, analysis of the use of statistical methods, and compared between two groups before and after treatment. Results the scores of the 1. comparison results before the treatment of the relevant information, the two groups in gender, age, course of disease and VAS, ROM and CMS shoulder function score, the difference was not statistically significant (P > 0.05), indicating that the two groups with.2. score of two groups after treatment of VAS, compared with before treatment were significantly decreased, the differences were statistically significant (P < 0.05), indicating that the two groups can improve therapy pain; compared with the control group, the observation group VAS score less than the conventional group, the difference was statistically significant (P < 0.05), the observation group to improve the degree of pain was higher than that of conventional group.3. of the two groups after treatment ROM score, compared with before treatment significantly Increased, the differences were statistically significant (P < 0.05), indicating that two groups of therapy can improve the activity; compared with the control group, the observation group ROM score higher than the normal group, the difference was statistically significant (P < 0.05), showed that the observation group than in the conventional group can improve the joint activity of.4. after treatment in two groups the CMS score, compared with before treatment were significantly increased, the differences were statistically significant (P < 0.05), indicating that two groups of therapy can improve the function of the shoulder joint; compared with the control group, the observation group CMS score higher than the normal group, the difference was statistically significant (P < 0.05), suggesting that compared the observation group in improving shoulder the joint function and treatment is better than the conventional group.5., two groups of therapy have achieved good results in clinical symptoms and improve the function of periarthritis of shoulder, the observation group, 7 cases were cured, 15 cases, effective 7 cases, invalid 1 cases, the total effective rate was 96.67%; While the control group, cured 4 cases, markedly 9 cases, effective 13 cases, invalid 4 cases, total effective rate compared to the overall curative effect of the 86.67%. two group, there were statistically significant differences (P < 0.05), the observation group is better than the conventional group. Conclusion this paper discusses electroacupuncture observation combined with the clinical curative effect of moxibustion treating scapulohumeral periarthritis, results showed that electroacupuncture therapy alone can effectively relieve pain, improve joint mobility and improve the function of the shoulder joint, and electro acupuncture combined with moxibustion therapy is better than the electro acupuncture therapy, therapeutic effect, high maneuverability, it is worthy of clinical application.

【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.9

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